Fox H
Department of Pathological Sciences, University of Manchester, UK.
Histopathology. 1993 Aug;23(2):103-10. doi: 10.1111/j.1365-2559.1993.tb00467.x.
Primary neoplasms of the female peritoneum may be mesothelial or Müllerian in nature. Primary mesotheliomas may be cystic, benign papillary or diffuse malignant. Primary Müllerian tumours of the peritoneum are thought to arise within the secondary Müllerian system: the overwhelming majority are serous in nature and probably develop from pre-existing endosalpingiosis. Primary peritoneal serous tumours of borderline malignancy are identical histologically to the peritoneal 'implants' found in association with ovarian serous tumours of borderline malignancy, whereas primary peritoneal serous adenocarcinomas are histologically identical to ovarian serous adenocarcinomas. The recognition of a primary peritoneal serous neoplasm of borderline malignancy rests on the presence of either normal ovaries, ovaries containing only a fully benign neoplasm or ovaries showing only minimal surface involvement. The diagnosis of a primary peritoneal serous adenocarcinoma is made if the ovaries are of normal size with either no tumour or only minimal surface involvement: in some cases normal ovaries will have previously been prophylactically removed because of a family history of ovarian cancer. The differential diagnosis between a primary serous adenocarcinoma and a diffuse malignant mesothelioma can be difficult and is often not resolved by either electronmicroscopy or immunocytochemistry.
女性腹膜的原发性肿瘤本质上可能是间皮性或苗勒管源性的。原发性间皮瘤可能是囊性、良性乳头状或弥漫性恶性的。腹膜原发性苗勒管肿瘤被认为起源于继发性苗勒管系统：绝大多数为浆液性，可能由先前存在的输卵管内膜异位症发展而来。原发性腹膜交界性浆液性肿瘤在组织学上与伴发于卵巢交界性浆液性肿瘤的腹膜“种植灶”相同，而原发性腹膜浆液性腺癌在组织学上与卵巢浆液性腺癌相同。原发性腹膜交界性浆液性肿瘤的诊断取决于是否存在正常卵巢、仅含有完全良性肿瘤的卵巢或仅显示轻微表面受累的卵巢。如果卵巢大小正常，无肿瘤或仅有轻微表面受累，则诊断为原发性腹膜浆液性腺癌：在某些情况下，由于卵巢癌家族史，正常卵巢此前已被预防性切除。原发性浆液性腺癌与弥漫性恶性间皮瘤之间的鉴别诊断可能很困难，通常电子显微镜检查或免疫细胞化学检查也无法解决。
